MCB 5252 - Exam 3 Study Guide (EU)

Name the general characteristics of Clostridium

Clostridium is a Gram (+) rod shaped bacilli. It forms spores, is an obligate anaerobe, and is highly toxigenic.

Botulinum toxin Organism: Mode of action: Effect on human body:

Botulinum toxin Organism: Clostridium botulinum Mode of action: At presynaptic nerve, blocks transmission of acetylcholine Effect on human body: Flaccid paralysis (death)

What are some diseases caused by Clostridium? explain

C. botulinum: Infant botulism (neurotoxin, an exotoxin)- flaccid paralysis, unable to swallow, etc. Foodborne illness - types A and B toxins cause (in canned foods) and E toxins (pre-served fish). Severe symptoms, including neurological. Wounds - rare. Gas gangrene. Inhalation - may be weaponized. C. tetani: tetanus. Sustained contraction of muscles. Drooling, sweating, irritability, persistent back spasms; eventual nervous system involvement with cardiac arrhythmia, fluctuation in bp, and dehydration. C.diff: Antibiotic-associated overgrowth in intestines. Pseudomembranous Colitis - type of colon infection. Because tight junction is gone. Toxic Megacolon - enlargement of colon. Perforation of Colon. Rare colonizer of healthy people.

Diseases caused by Bacillus anthracis (Explain what it is)

Cutaneous anthrax: painless papule progresses to ulceration with surrounding vesicles and then to eschar formation. Gastrointestinal anthrax: ulcers at the site of invasion Inhalation anthrax: initial nonspecific, rapid onset of sepsis with fever, edema and lymphadenopathy; meningeal symptoms. Rapid death w/o antibiotics.

action of exotoxins produced by Staph ____ - toxic to many cells. ___ - encoded by chromosome and a plasmid. Disrupts smooth muscle in blood vessels and causes tissue damage. Also a pore forming toxin, disrupts ions. ____ - specificity for sphingomyelin.

Cytotoxins - toxic to many cells. Alpha toxin - encoded by chromosome and a plasmid. Disrupts smooth muscle in blood vessels and causes tissue damage. Also a pore forming toxin, disrupts ions. Beta toxin- specificity for sphingomyelin.

11.What are the action of exotoxins produced by Staph?

Cytotoxins, alpha toxin, beta, Exfoliative toxin, Exfoliative toxin A, Exfoliative toxin b, enterotoxin, TSST

40.What are the possible complications of gonorrhea

Bacteremia leading to disseminated gonococcal infection. The skin and joints may be involved and lead to arthritis, caused by increased quantity of synovial fluid and pressure. Prostate infection in males, can make you more prone towards other infections.

What is the significance of yersina pestis (plague) ability to grow at high/low temp?

Below 27 degrees Celsius, in fleas, the blood clots making digestion impossible. Due to this the fleas bite more hosts spreading the disease.

19.Name three organisms that cause UTI. Which one is the most frequent cause

E. coli, Klebsiella, Enterobacter, Proteus, Serratia, Citrobacter. E. coli is most frequent.

Enterotoxigenic E. coli Toxins produced: Effect:

Enterotoxigenic E. coli Toxins produced: LT and ST toxins Effect: both disrupt ion uptake but don't cause tissue damage

T.F Yersinia pestis an obligate intracellular pathogen

False, facultative

39.What are the main virulence factors of N. meningitidis? What are Petechiae?

Fimbria for attachment, capsule, and LOS (endotoxin) Ecchymosis - large, irregular hemorrhagic areas of the skin Petechiae - small, purplish, hemorrhagic spots on the skin. Due to meningitis.

What are the significance of Pseudomonas infections

GNR that is more resistant than others to disinfectant, antibiotics, and other chemicals due to a specialized porin. Most common opportunistic infection. Is ubiquitous and an opportunistic infection for immunocompromised patients. Also causes UTI, ear infections. Secondary bacterial infections in burn victims.

What are some diseases caused by Helicobacter?

Gastritis, peptic ulcers, gastric adenocarcinoma. Lifelong colonization in stomach of untreated humans.

What are some diseases caused by salmonella? Explain

Gastroenteritis (small intestine): fever, nausea, vomiting, bloody or nonbloody diarrhea, abdominal cramps. Due to eating contaminated food (poultry, eggs, dairy). Direct fecal-oral in children. 6-48 hours after eating. Enteric fever: typhoid fever, paratyphoid fever. The bacteria pass through cells lining the intestines and are engulfed by macrophages. They replicate after being transported to the liver, spleen, and bone marrow. Gradual increasing fever, malaise, followed by GI symptoms. Has a bacteremic phase, followed by colonization of gallbladder and reinfection of intestines. Bacteremia: most common with Salmonella typhi, paratyphi and choleraesuis. Asymptomatic colonization: Salmonella typi and paratyphi. Usually in gallbladder.

What are some diseases caused by shigella? Explain

Gastroenteritis (small intestine, then large intestine): Initial watery diarrhea progresses to abdominal cramps and possible bloody stool. Humans are only reservoir. Low inoculum, person-to-person (fecal-oral especially). More common in children. First colonizes the small intestine (watery diarrhea), then the colon (bloody, pus). Bacterial dysentery: Severe form of disease, caused by virulent species S. dysenteriae. Asymptomatic carriage: in a small number of people colonizes the colon.

27.List the zoonotic diseases (lecture notes and required readings)

The zoonotic diseases include: a. Bacillus anthracis (anthrax): from work with cattle (spores). b. Arthropod borne (Rickettsia, Lyme disease). Lyme disease: Borrelia burgdorferi (ticks) c. Plague: Yersinia pestis (wild rodent-->flea---> domestic animals/humans)

14.What are the virulence factors of group of Enterobacteriaceae?

Their virulence factors include the endotoxin lipid A, exotoxins, enterotoxins, cytotoxins, as well as their invasiveness

46. What makes developing vaccine against Neisseria difficult

There is antigenic variation of the pili. For vaccines want the body to produce IgA - increase mucosal immunity. Body produces a lot of IgA in vaginal area. Difficult to produce a vaccine because pili is not a good, stable protein, this one changes. The pilin proteins have a conserved and a highly variable region.

36.What are the major characteristics of S. mutans?

Tooth Decay - Streptococcus Mu tansAdhesin: Glucan attaches the bacteria to the teeth and allows them to make a biofilm. Ferments sugars to make lactic acid to erode the teeth. It not what causes gum disease : gingivitis.

Toxin A and B Organism: Mode of action: Effect on human body:

Toxin A and B Organism: Clostridium difficile Mode of action: Modifies Rho, a subfamily of small GTP- binding proteins that are regulators of the actin cytoskeleton. Deamidation of the glutamine residue at position 63 of Rho to a glutamic acid produces a dominant active Rho protein unable to hydrolyze bound GTP Effect on human body: Cell necrosis and bloody diarrhea associated with colitis

Diseases caused by C. diptheriae (Explain what it is)

Respiratory: sudden onset of exudative pharyngitis, sore throat, low-grade fever, and malaise. A thick pseudomembrane develops over the pharynx. Cutaneous: a papule can develop on the skin, progresses to non healing ulcer, systemic signs can develop.

Organism: GAS (Strep pyogenes) Name diseases caused that are non-Suppurative infections:

Rheumatic fever, Acute glomerulonephritis

ST (heat stable) toxin Organism: Mode of action: Effect on human body:

ST (heat stable) toxin Organism: Enterotoxigenic E. coli Mode of action: Similar to cholera toxin. Binding of the heat- stable enterotoxins to a guanylate cyclase receptor results in an increase in cyclic GMP that adversely affects electrolyte flux. Promotes secretion of water and electrolytes from intestinal epithelium leading to diarrhea Effect on human body: Disrupt ion uptake, cause watery diarrhea. They do not damage tissues.

Organism: A.aureus Name diseases caused that are toxin mediated

Scalded Skin Syndrome (only in Staph) Food poisoning (also in other enterotoxin-forming bacteria) Toxic shock (similar in S. pyogenes)

Tetnaus Organism: Mode of action: Effect on human body:

Tetnaus Organism: Clostridium tetani Mode of action: At presynaptic blocks transmission of inhibitory NT (glycine, GABA) Effect on human body: Rigid paralysis (death)

14.What are the diseases caused by Enterobacteriaceae?

The diseases caused by enterobacteriaceae include Gastroenteritis, Septicemia, enteric fever, pneumonia, and UTI.

What diseases are caused by Strep. pnuemoniae ?

The diseases caused by pneumolysin include pneumonia, otitis media, meningitis and septicemia.

58.(T/F) M. tuberculosis (causative agent of TB) can live as a facultative intracellular parasite in macrophages. Name other bacteria discussed in this course that can live as facultative intracellular parasites

True. Mycobacterium, Salmonella, Yersinia pestis Treponema pallidum, Mycoplasma, Rickettsia and Chlamydia are obligate intracellular parasites. Rickettsia and Chlamydiae are similar to viruses. Differences is that viruses rely on host transcription, translation, replication, metabolism. Bacteria do their own, some rely on metabolism like ATP though. We call these energy parasites. Chlamydiae are unable to produce ATP and are energy-parasites.

What causes fleas to have blood clots making digestion impossible when infected with yersina (plague)?

Type III secretion mechanism injects into the phagocytic cells that prevents them from being able to properly eat them causing the phagocytic failure that makes them a facultative intracellular pathogen.

What are some diseases caused by chlamydia? Explain

Urogenital infections: no pus, not a lot of tissue damage. Lymphogranuloma vereenum (LGV) PID: same as N. gon. Trachoma: Eye infection that can be transmitted through direct contact, fomites such as towels, flies. Results in inverted eyelash, touches cornea and damages the surface. Eventually leads to scarring of cornea - cannot be repaired, leads to blindness. Simple antibiotic treatment. Conjunctivitis Mostly asymptomatic infection Most commonly reported STD in the US Age: persons aged 15 -24 years; Teenage girls are highest risk Affects both male and female; the ratio is 1:1

Is there a vaccine against strep. pnuemoniae? Is so what is it?

Vaccine available against the capsule since the bacteria is harmless without the capsule that is the important thing to target.

12.List enzymes possessed by Staph and describe their modes of action (lecture notes and required readings) e. ____: kills WBC putting holes in their cytoplasmic membrane f. ____- breaks down fats by hydrolyzing the bond between glycerol and the fatty acids g. ___: degrade collagen and other tissues h. ____ bind to the Fc portion of an antibody so they can't attach to WBCs, inhibits phagocytosis.

e. leukocidin: kills WBC putting holes in their cytoplasmic membrane f. lipase- breaks down fats by hydrolyzing the bond between glycerol and the fatty acids g. protease :degrade collagen and other tissues h. protein A: bind to the Fc portion of an antibody so they can't attach to WBCs, inhibits phagocytosis.

What are the virulence factors of shiga like toxin?

factors: adhesins, pili, toxins: LT I and II, STa and STb, shiga-like (SLT i and II), hemolysin- kill RBC

What are the important features of group A streptococci? List virulence factors

i. GPC chains, have special C-Carbohydrates that are used in their serological testing b. Virulence Factors: M-Protein, Capsule, hyaluronidase, exotoxin: streptolysin. Beta Hemolysis

12.List enzymes possessed by Staph and describe their modes of action (lecture notes and required readings) i. ____: Causes rash, diarrhea, and shock j. ____: severe diarrhea k. _____: cytolytic

i. Toxic Shock Syndrome toxin: Causes rash, diarrhea, and shock j. Enterotoxin: severe diarrhea k. Alpha and Beta toxin: cytolytic

45.What are the important characteristics of Trachoma

inverted eyelash scratches and scars the cornea resulting in permanent blindness.

j. Capsules, protein A and enzymes that interfere with _____ by phagocytes k. ____ ( made by: ____): makes a fibrinogen ball around the bacteria protecting it from phagocytosis l. ____ (made by: ____): binds to plasminogen and produces plasmin to break down the fibrin clots allowing the pathogen to free itself and move from a clotted area. m. _____ (made by: ____): breaks down collagen (connective tissue framework) so pathogen can spread

j. Capsules, protein A and enzymes that interfere with phagocytosis by phagocytes k. Coagulase ( made by: s. aureus): makes a fibrinogen ball around the bacteria protecting it from phagocytosis l. Streptokinase (made by: Strep): binds to plasminogen and produces plasmin to break down the fibrin clots allowing the pathogen to free itself and move from a clotted area. m. Collagenase (made by: Clostridia): breaks down collagen (connective tissue framework) so pathogen can spread

n. ______ (made by: ______): lowers visocity of exudates giving pathogen more mobility o. ______(made by: ___): cleaves laminin associated with basement membranes p. _____(made by: ____): Lyses RBCs for Iron q. ____ (made by: _____: hydrolyzes hyaluronic acid which is what holds cells together and leaves the intercellular space open to invasion

n. Deoxyribonuclease (made by: Strep/Staph/C.perfringens): lowers visocity of exudates giving pathogen more mobility o. Elastase/alkaline protease (made by: Ps.A): cleaves laminin associated with basement membranes p. Hemolysins(made by: Staph, Strep, E.coli, C.perfringens): Lyses RBCs for Iron q. Hyaluronidase (made by: Strep, Staph, clostridia): hydrolyzes hyaluronic acid which is what holds cells together and leaves the intercellular space open to invasion

What are the major characteristics of Mycoplasma?

primary atypical pneumonia: It has no cell wall, very small

r._______ (made by: _____): Metabolic wastes that damage epithelia in respiratory and urogenital tracts. s. _____ (made by: ____): Cleaves IgA t. _____ (made by: _____): Destroys lecithin/phosphatidylcholine- components of the plasma membrane- allowing the pathogen to spread u. _____ (made by: _____):decrease host resistence by killing WBCs by poking hole with pores formers.

r. Hydrogen peroxide/Ammonia (made by: Myco/Ureaplasma): Metabolic wastes that damage epithelia in respiratory and urogenital tracts. s. Immunoglobulin A protease (made by: S.pneumo): Cleaves IgA t. Lecinthinase or phospholipase (made by: Clostridia): Destroys lecithin/phosphatidylcholine- components of the plasma membrane- allowing the pathogen to spread u. Leukocidins (made by: Staph, Strep, Pneumococcal):decrease host resistence by killing WBCs by poking hole with pores formers.

v. ____ (made by: ____): inhibits leukocyte phagocytosis by activating the adenylate cyclase system w. ____made by: ____): binds IgG on the Fc end preventing it from interacting with complement x. _____(made by: _____): Degrades proteins

v. Porins (made by: Salmonella): inhibits leukocyte phagocytosis by activating the adenylate cyclase system w. Protien A/G (made by: Staph/Strep): binds IgG on the Fc end preventing it from interacting with complement x. Pyrogenic exotoxin B (made by: Group A Strep): Degrades proteins

What are some thinsg that can make you more predisposed to Strep. pnuemoniae ?

viral infection, cardiac failure, alcohol addiction or anything that can interfere with the cough/epiglottal reflex and ciliary action

14.What are the general characteristics of group of Enterobacteriaceae? List members and diseases caused by them.

Enterobacteriaceae are Gram negative rods with a facultative anaerobic metabolism which is found in the intestines. They ferment glucose

Enterohemorrhagic E. coli Toxins produced: Effect:

Enterohemorrhagic E. coli Toxins produced: Shiga-like toxin Effect: Nosocomial infection

How is plague transmitted?

Transmission: Wild rodent -> flea -> other rodents, and humans

T.F A streptococci is found in the normal flora

True

What are the three stages that you can have with TB?

1. Latency and dormancy of illness. Treatment depends on if it is active or inactive. Inactive - just give isoniazide. If you have HIV, you have to take prophylaxis because you get sick easily. Skin test and x- ray. 2. Spread. Can become disseminated and spread throughout the body. Many tubercles, miliary tuberculosis, spread through lung tissues. Even death can occur. Recognize with x-ray and skin test. 3. Active. Can become active after latent infection. Lung infection is an active infection and sometimes stays in this area and erodes alveoli and passages. X-ray is needed. Sputum tested for acid fast bacteria. This is the point where immunity develops.

22.What are the possible pathogenesis outcomes of bacteria transmitted by the enteric route

1. Mucosal Adherence without invasion or damaging cells : i.e. V. cholerae: produce a toxin that disrupts cAMP level and ion uptake producing watery diarrhea. Enterotoxins are produced. 2. Mucosal Invasion with cellular damage: blood and pus with tissue loss i.e. Shiga toxin: disrupt eukaryotic protein synthesis mechanism. The cells or the submucosal area is invaded. 3. Mucosal translocation: This is a generalized infection where bacteria pass through the mucosal layer and throughout the body (possibly using macrophages). Symptoms include fever, shock, and there is little or no intestinal disease. I.e. Salmonella, typhoid fever

Word bank: Mucosal Adherence without invasion or damaging cells, Mucosal Invasion with cellular damage, Mucosal translocation: 1. _____: i.e. V. cholerae: produce a toxin that disrupts cAMP level and ion uptake producing watery diarrhea. Enterotoxins are produced. 2. ______: blood and pus with tissue loss i.e. Shiga toxin: disrupt eukaryotic protein synthesis mechanism. The cells or the submucosal area is invaded. 3. _____This is a generalized infection where bacteria pass through the mucosal layer and throughout the body (possibly using macrophages). Symptoms include fever, shock, and there is little or no intestinal disease. I.e. Salmonella, typhoid fever

1. Mucosal Adherence without invasion or damaging cells : i.e. V. cholerae: produce a toxin that disrupts cAMP level and ion uptake producing watery diarrhea. Enterotoxins are produced. 2. Mucosal Invasion with cellular damage: blood and pus with tissue loss i.e. Shiga toxin: disrupt eukaryotic protein synthesis mechanism. The cells or the submucosal area is invaded. 3. Mucosal translocation: This is a generalized infection where bacteria pass through the mucosal layer and throughout the body (possibly using macrophages). Symptoms include fever, shock, and there is little or no intestinal disease. I.e. Salmonella, typhoid fever

What are some diseases caused by Campylobacter?

Acute enteritis with diarrhea, malaise, fever and abdominal pain. Guillaine-Barre syndrome. Campylobacter jejuni diarrhea (common in summer), especially in children. Causes damage to the mucosal surfaces of the jejunum, ileum and colon (bloody).

Alpha toxin Organism: Mode of action: Effect on human body:

Alpha toxin Organism: S. Aureus Clostridium perfringens Mode of action: Protein subunits assemble into an oligomeric structure that forms an ion channel in the plasma membrane Effect on human body: Disrupts smooth muscle in blood vessels and causes tissue damage. Also a pore forming toxin, disrupts ions.

34.What is the significance or tubercle in diagnosis of TB agent

Breathe disease, goes to bronchioles and alveoli, alveoli have macrophages that eat, become intracellular parasites. Macrophages surround over and over and becomes tubercle, a hard shell around it. This is full of bacteria, inside becomes liquefied and bacteria can escape and re-enter the system. Take an x-ray the tubercle will show up and is diagnostic of disease. Disease gets into the lung and can spread to rest of the body. Miliary is spread to the rest of the body, such as organs, lung, heart.

____ Plague: The regional lymph nodes become infected( ___ form which are enlarged and tender lymph nodes. Additional symptoms include fever and pain in the limbs) c. ____ Plague: occurs if the infection is not contained in the regional lymph nodes and it spreads to the liver and lungs d. _____ Plague: is infection of the lungs which then enables spreading by aerosols. The spread is rapid and has a high fatality rate

Bubonic Plague: The regional lymph nodes become infected( Buboes form which are enlarged and tender lymph nodes. Additional symptoms include fever and pain in the limbs) c. Septicemic Plague: occurs if the infection is not contained in the regional lymph nodes and it spreads to the liver and lungs d. Pneumonic Plague: is infection of the lungs which then enables spreading by aerosols. The spread is rapid and has a high fatality rate

44.What is the first sign of gonococcal infection in male

Burning urination with pus filled yellowish discharge

37.Name diseases caused by Chlamydia. What are the significance of PID

C. trachomatis infection may be primary or a chronic recurrence/re-infection. STIs, lymphogranuloma vereenum, pelvic inflammatory disease, trachoma, conjunctivitis, and pneumonia. Mostly asymptomatic. It causes urethritis in men and mucopurulent cervicitis, urethritis, and endometritis in women. Women (more severe): Salpingitis (inflammation of fallopian tubes), endometritis, pelvic inflammatory disease (PID), ectopic pregnancy and tubal factor infertility. PID may result in salpingitis, uterine tube infection, results in ectopic pregnancy or sterility. Miscarriage. It is associated with an increased risk for the transmission or acquisition of HIV and is also attributed to be a risk factor for the development of cervical carcinoma.

What are the enzymes produced by staph?

Capsule, coagulase, Exfoliatin, hyaluronidase, leukocidin, lipase, protease, protein A, toxic shock syndrome toxin, enterotoxin, alpha A and B toxin

Cholera toxin Organism: Mode of action: Effect on human body:

Cholera toxin Organism: Vibrio cholerae Mode of action: ADP ribosylation of G proteins stimulates adenylate cyclase and increases cAMP in cells Watery diarrhea and severe dehydration of the GI tract, causing secretion of water and electrolytes leading to diarrhea Effect on human body: Watery diarrhea and severe dehydration

What are some diseases caused by Vibrio cholerae? Expain

Cholera: begins with an abrupt onset of watery diarrhea and vomiting and can progress to a severe dehydration, metabolic acidosis and hypokalemia and hypovolemic shock. Stool is colorless, odorless, free of protein and is speckled with mucus ("rice water" stools). Requires fluid therapy. Spread by contaminated water and food rather than person-to-person. Requires a high inoculum in normal gastric acidity. Gastroenteritis: milder form in toxin-negative strains. Wound infections (V. vulnificus and V. parahaemolyticus): exposure to contaminated water.

1. List and define selected types of Infections (just the terms)

Chronic b. Fulminating c. Latent d. Nosocomial e. Opportunistic f. Polymicrobial g. PYOgenic

25.What are the main characteristics of CDAD

Clostridium difficile-Associated Disease is characterized by the following: a. Antibiotic associated diarrhea b. Pseudomembranous Colitis c. Toxic Megacolon d. Perforation of Colon e. Asymptomatic infections

57.What is meant by Miliary tuberculosis?

Disease gets into the lung and can spread to rest of the body. Miliary is spread to the rest of the body, such as organs, lung, heart.

Diseases caused by Mycobacterium tuberculosis

Disease is primarily due from host response to infection. Pulmonary, but can disseminate to any body site in immunocompromised.

Name the diseases caused by Clostridium

Diseases associated with Clostridium include Gas gangrene, tetanus, botulism, and, in association with Clostridium difficile, diarrhea,Pseudomembranous colitis, toxic megacolon, as well as perforation of the colon.

8. What are the important features of Strep. pyogenes? List its virulence factors and their significances

Enzymes: Streptolysin S and O, Streptokinase A and B, DNAses. Streptolysin O - pore forming toxin. Insert a transmembranous pore into a host cell membrane, thereby disrupting the selective influx and efflux of ions across the membrane. Exotoxins - act as superantigens Other virulence factors: Capsule, M proteins (interfere with phags), C5a peptidase on surface inactivates C5a, adherence to host cells (F protein adhesins, also M protein and lipotechoic acid), invade into epithelial cells (mediated by M and F protein). Hyaluronidase and Streptolysin.

action of exotoxins produced by Staph ____ - Serine proteases that split the intercellular bridges in the stratum granulosum epidermis.cellular bridges in the stratum granulosum epidermis. ____ - phage associated, heat stable. _____- on a plasmid, heat liable. ____ - Common in food poisoning. ____ (stimulate proliferation of T cells and release of cytokines); stimulate release of inflammatory mediators in mast cells, increasing intestinal peristalis and fluid loss, as well as nausea and vomiting. ____ - Superantigen produces leakage or cellular destruction of endothelial cells.

Exfoliative toxins - Serine proteases that split the intercellular bridges in the stratum granulosum epidermis.cellular bridges in the stratum granulosum epidermis. Exfoliative toxin A - phage associated, heat stable. Exfoliative toxin B- on a plasmid, heat liable. Enterotoxins - Common in food poisoning. Superantigens (stimulate proliferation of T cells and release of cytokines); stimulate release of inflammatory mediators in mast cells, increasing intestinal peristalis and fluid loss, as well as nausea and vomiting. TSST - Superantigen produces leakage or cellular destruction of endothelial cells.

Compare endotoxins and exotoxins. Examples? (lecture notes and required readings)

Exotoxins: · Soluble, heat-labile, proteins, produced and released, highly immunogenic, some highly lethal · Most exotoxin producers are G (+) · Often travel from site of infection to other tissues or cells where they exert their effects · Bacteria may have toxin genes in their plasmids or prophage DNA · Types of Exotoxins: -AB Exotoxins -Specific host site exotoxins -Membrane-disrupting exotoxins -Super antigens that stimulate T cells directly to make cytokines Endotoxin · LPS in G (-) outer membrane can be toxic to hosts · Toxic component is the Lipid A · Usually capable of producing general systemic effects: -Fever, shock, blood coagulation, inflammation, hemorrhage · Bring about these effects indirectly: -Endotoxin interacts with host molecules and cells, activating host systems -Stimulate macrophages to release endogenous pyrogen (induces fever) -Release of cytokines to cause septic shock · G (-) septicemia · Causative agents: G (-) more fatal, shock despite treatment: Escherichia, Pseudomonas · Symptoms: violent shaking,chills, fever, anxiety and rapid breathing -in case of septic shock: urine output drops, respiration and pulse becomes more rapid, arms and legs become cool and dusky colored · Pathogenesis: - Generally originates outside bloodstream: alterations in normal body defenses may allow organisms to infect blood - endotoxin is released: antibiotics can enhance endotoxin release - macrophages respond intensely to endotoxin to try and localize; if not: endotoxin enters the bloodstream -Lungs particularly susceptible to irreversible damage

What diseases are caused by E. coli? Explain

Extraintestinal: bacteremia, neonatal meningitis, UTI, and intraabdominal infections. Acquired endogenously (patient's own microbial flora). Adhesions (P pili) bind to cells lining the bladder and upper respiratory tract. Gastroenteritis - acquired exogenously. 1. Enterotoxigenic ETEC (small intestine) : in developing countries. Traveler's diarrhea. Need large quantities of microbe to make ill. Watery diarrhea, cramps, vomiting, low-grade fever. Caused by plasmid-mediated, heat stable/heat labile enterotoxins that stimulate hypersecretion of fluids and electrolytes. 2. Enterohemorrhagic EHEC (large intestine): Watery diarrhea initially, turns to bloody (hemorrhagic colitis) with abdominal cramps; little or no fever. Can progress to hemolytic uremic syndrome. EHEC evolved from enteropathogenic E coli (EPEC), has A/E lesions with destruction of intestinal microvilli resulting in decreased absorption. Pathology mediated by cytotoxic Shiga toxins (stx 1 and 2) which disrupt protein synthesis.stoo

56. List bacterial infections discussed in class that can result in arthritis?

Gonorrhea, Borellia burgdorferi ***Staphylococcus aureus - see slide 19! (Current research also points to cases of secondary arthritis from syphilitic infections, not mentioned or included in lectures/readings?)

Identify the diseases by Neisseria ____ 2-5 days incubation. Adult males have yellow pus filled urithmitis, due to tissue destruction. Females get cervixitis not vaginal so much. Attach to epithelial cells, engulfed, transported to the sub mucosal, results in irritation and clinical symptoms. Doesn't have affinity for vaginal because it goes submucosal, beyond that area. Vaginal discharge and abdominal pain, painful and burning urine. Easily treated with penicillin. _________ (eye infection in babies). Newborns may become infected during birth to an infected mother. Treatment of newborn's eyes with silver nitrate, tetracycline or erythromycin prevents eye infections. Easily killed in the environment, not transmitted by fomites. Needs direct contact. _____Signs/Symptoms: Inflammation, fever, abdominal pain, back pain. Incubation period: Months to years after infection. At risk are Women with untreated gonorrhea or chlamydial infection. May result in Salpingitis, uterine tube infection, results in ectopic pregnancy or sterility. Miscarriage. Can become systemic infection, bacteremia, spread to joints. Can cause arthritis.

Gonorrhea: 2-5 days incubation. Adult males have yellow pus filled urithmitis, due to tissue destruction. Females get cervixitis not vaginal so much. Attach to epithelial cells, engulfed, transported to the sub mucosal, results in irritation and clinical symptoms. Doesn't have affinity for vaginal because it goes submucosal, beyond that area. Vaginal discharge and abdominal pain, painful and burning urine. Easily treated with penicillin. Eye infection: Opthalmia neonatum (eye infection in babies). Newborns may become infected during birth to an infected mother. Treatment of newborn's eyes with silver nitrate, tetracycline or erythromycin prevents eye infections. Easily killed in the environment, not transmitted by fomites. Needs direct contact. Pelvic Inflammatory Disease (PID): Signs/Symptoms: Inflammation, fever, abdominal pain, back pain. Incubation period: Months to years after infection. At risk are Women with untreated gonorrhea or chlamydial infection. May result in Salpingitis, uterine tube infection, results in ectopic pregnancy or sterility. Miscarriage. Can become systemic infection, bacteremia, spread to joints. Can cause arthritis.

What are the major characteristics of Helicobacter infections?

Helicobacter pylori (peptic ulcers): abdominal pain, tenderness, bleeding. Bacteria survive extreme acidity of the stomach. Able to neutralize environment. Organism uses flagella to corkscrew through mucosal lining. Inflammatory response begins.Mucus production decreases. Without mucus stomach lining not protected from acidic environment Infection persists for years. Possibly for a lifetime. Antibiotics for a few weeks with multiple antibiotics. Can lead to stomach cancer.

Organism: A.aureus Name diseases caused that are Suppurative (pus forming) infections:

Impetigo (also in S. pyogenes), Folliculitis, Carbuncles, Pneumonia and empyema, Wound infections, Nosocomial infections Other (Bacteremia, endocarditis, arthritis, osteomyelitis)

Organism: A.aureus (Suppurative (pus forming) infections): _____ (also in S. pyogenes): localized cutaneous infection with pus filled vesicle on an erythematous (red, inflammation) base. Highly concocciautagious. Full of bacteria can be transferred person to person. Easily treated with antibiotics. _____: impetigo of hair follicles _____ large, painful, pus-filled cutaneous nodules. _____: coalescence of furnucles with extension into the subcutaneous tissues and evidence of systemic disease (fever, chills, bacteremia).

Impetigo (also in S. pyogenes): localized cutaneous infection with pus filled vesicle on an erythematous (red, inflammation) base. Highly concocciautagious. Full of bacteria can be transferred person to person. Easily treated with antibiotics. Folliculitis: impetigo of hair follicles Furuncles or boils: large, painful, pus-filled cutaneous nodules. Carbuncles: coalescence of furnucles with extension into the subcutaneous tissues and evidence of systemic disease (fever, chills, bacteremia).

List the disease caused by both Streptococci and Staphylococci

Impetigo, toxic shock syndrome, wound infections.

Organism: GAS (Strep pyogenes (Suppurative infections): ____: localized cutaneous infection with pus filled vesicle on an erythematous (red, inflammation) base. Highly concocciautagious. Full of bacteria can be transferred person to person. Easily treated with antibiotics. _____: deep infection of skin that involves destruction of muscle and fat layers. _____ similar to staph-mediated but patients are bacteremic and with evidence of fasciitis. Produce heat labile exotoxins that act as superantigens, interacting with both macrophages and T helper cells, which enhance the release of proinflammatory cytokines.

Impetigo: localized cutaneous infection with pus filled vesicle on an erythematous (red, inflammation) base. Highly concocciautagious. Full of bacteria can be transferred person to person. Easily treated with antibiotics. Necrotizing fasciitis: deep infection of skin that involves destruction of muscle and fat layers. Strep Shock Syndrome: similar to staph-mediated but patients are bacteremic and with evidence of fasciitis. Produce heat labile exotoxins that act as superantigens, interacting with both macrophages and T helper cells, which enhance the release of proinflammatory cytokines.

7. What are the important features of TSST? (lecture notes and required readings)

In S. aureus. Toxic shock syndrome toxin is a chromosomally mediated exotoxin and is a superantigen that stimulates release of cytokines, producing leakage of endothelial cells at low concentrations and a cytotoxic effect to the cells at high concentrations. Has an ability to penetrate mucosal barriers, even though infection is localized, which is why systemic effects occur. Hypovolemic shock and multiorgan failure can occur. Symptoms are fever, hypotension, diffuse macular erythematous rash.

31.TB What are the treatment options available for TB patients

Inactive - just give isoniazide. If you have HIV, take prophylaxis because you get sick easily. Active - isoniazide + rifampin. Some resistance with disease (multi-drug resistance, also extensively resistant TB), including these two drugs. . If typical TB, doctor gives you antibiotics and you are OK in a few weeks. If multi-drug resistant, takes many months and hospitalization to treat. Also has super resistance

38.What are the characteristics of the two forms of Chlamydia

Infectious Elementary bodies(small): attaches to the host and enters into the host. It is inactive and only uses an attachment capacity to get into the host. It will evolve into the 2nd stage. Extracelllular infetious form. ii. Non-infectious Reticulate bodies(large): Stage 2. Is the one inside the host that is producing little daughter cells. It is larger and uses the ATP from the host to accomplish it's goals.

32.What are the characteristics of TB skin test? What material is used in the test

Intracutaneous injection protein derivatives. Not from TB, it is a cousin. The protein pieces are the same. Read within 48-72 hrs. Measure the bump, based on diameter. Case of CMI. This takes time to develop. Will have antibody against the TB.

14.What are the main antigentic characteristics of Enterobacteriaceae?

K-Capsule, H-Flagella, and O-somatic

LT (heat liable) toxin Organism: Mode of action: Effect on human body:

LT (heat liable) toxin Organism: Enterotoxigenic E. coli Mode of action: (similar to cholera toxin)ADP ribosylation of G proteins stimulates adenylate cyclase and increases cAMP in cells Watery diarrhea and severe dehydration of the GI tract, causing secretion of water and electrolytes leading to diarrhea Effect on human body: Disrupt ion uptake, cause watery diarrhea. They do not damage tissues.

Lipid A Organism: Mode of action: Effect on human body:

Lipid A Organism: Gram negative organisms (GNR, Neisseria, etc,) Mode of action: Endotoxin interacts with host molecules and cells, activating host systems. Stimulate macrophages to release endogenous pyrogen (induces fever, IL-1). Release of cytokines to cause septic shock. Effect on human body: Cause septic shock, similar to super antigens.

29.What is the significance of the cell wall of the TB agent? What is the mechanism of pathogenicity of TB agent

Lipid-rich cell wall, makes resistant to disinfectants, detergents, common antibacterial antibiotics, host immune response, and traditional stains. (Is susceptible to heat!) Cell wall (mycolic acid) is also toxic to Eukaryotes. Capable of intracellular growth in alveolar macrophages. Prevents fusion of phagosome with lysosomes. Can be carried throughout the body by macrophages.

30.What are the main clinical manifestations of TB

Miliary tuberculosis Organs/Tissues Lung, Heart, Liver Lymph nodes Bones and joints GI tract, Urogenital tract

33.Which of the diseases discussed in this section have a form of vaccine available for them

Mycobacterium tuberculosis, Pneumonia (S. pneumoniae), H. influenzae, Meningococcal strains

21.Name several bacteria that exist in intracellular form.

Mycoplasma, Rickettsia, Mycobacterium, Salmonella, Yersinia pestis, Chlamydia, Treponema pallidum

What are some diseases caused by Neisseria (just list diseases)

N. gonorrhea, Meningitis (N. meningitidis), Skin infection (N. men) : Ecchymosis, Petechiae, Gonorrhea, Eye infection: Opthalmia neonatum (eye infection in babies), Pelvic Inflammatory Disease (PID)

Identify the diseases by Neisseria _____: is transmission by direct contact, Mucous membranes of genitalia affinity. Is not washed away, sticks to area due to pili. _____: Normal flora. Colonization of the nasal passages; Infection or carrier state. Those who have problems with the complement system have more chance to get sick as a carrier. Complement plays a role in removing this bacteria. Mild fever, pharyngitis develops. Septicemia, septic shock-Endotoxin; Inflammation of the brain and spinal cord. Skin lesions on the trunk and lower extremities are common. High mortality (85%) if untreated, otherwise no long-lasting symptoms if treated. ____: Ecchymosis - large, irregular hemorrhagic areas of the skin. ____ - small, purplish, hemorrhagic spots on the skin.

N. gonorrhea: is transmission by direct contact, Mucous membranes of genitalia affinity. Is not washed away, sticks to area due to pili. Meningitis (N. meningitidis): Normal flora. Colonization of the nasal passages; Infection or carrier state. Those who have problems with the complement system have more chance to get sick as a carrier. Complement plays a role in removing this bacteria. Mild fever, pharyngitis develops. Septicemia, septic shock-Endotoxin; Inflammation of the brain and spinal cord. Skin lesions on the trunk and lower extremities are common. High mortality (85%) if untreated, otherwise no long-lasting symptoms if treated. Skin infection (N. men) : Ecchymosis - large, irregular hemorrhagic areas of the skin. Petechiae - small, purplish, hemorrhagic spots on the skin.

Diseases caused by Listeria monocytogenes(Explain what it is)

Neonatal disease: disseminated abscesses in multiple organs. Meningitis or meningoencephalitis with septicemia. Disease in healthy adults: typically influenza-like with or without gastroenteritis. Watery diarrhea. Meningitis: in adults, is most common form of disseminated disease. High mortality.

28.What are the major virulence factors of M. tuberculosis

No specific virulence factors but has an unusual cell wal. Does not produce a specific toxin. Has a capsule - prevents fusion between lysosome and phagosome (phagocytic failure). Macrophages fail to kill organism.

What are the major characteristics of Treponema

Obligate intracellular parasite/Strict parasite- exception to Koch's postulate because it needs human cells to grow. Spirochete. Makes hard lesions aka chancre. 10-90 days Primary Chancre, 6wks to 6 months latent til 2ndary infection then 4-12 weeks of secondary eruptions, then latency for 10+ years then tertiary breakout.

What are some diseases caused by Enterobacteria ceae

Respiratory, meningitis, bacteremia/sepsis, GI infections, UTI.

41.How Chlamydia is different from all other bacteria discussed in this section

Once mistaken for a virus. Too small to be a bacterium. Obligate intracellular parasite, cannot produce its own ATP - energy parasite. They have an inner and outer membrane that is similar to G- organisms but they do not possess a peptidoglycan layer cell wall like the typical G- (so it has an atypical cell envelope and they can be described as not having a cell wall). You cannot perform a gram stain on this organism. Yet it is killed by antibiotics and it has ribosome, DNA and RNA (viruses never have both - have one or the other). Like Syphilis, it does not grow on routine media - need cell culture and restricted range of cells that they infect. Has a limited host cell range of non-ciliated epithelial cells and has two forms (reticulate and elementary bodies).

What are some diseases caused by Pseudomonas?

Opportunistic infections, including UTIs, ear infections and skin infections (burn victims).

Diseases cased by Strep pneumoniae? Explain what it is

Otitis media Pneumonia, pneumococcial pneumonia: acute onset with severe chills and sustained fever. Septicemia/bacteremia: more common in patients with meningitis. Meningitis: mostly due to bacteremia. Deadly form. Higher than from other bacteria. One of most deadly meningitis forms. Bacterial in general is more serious than viral.

do antibiotics work against Strep. pnuemoniae?

Penicillin is also generally effective but there are some that are resistant.

Organism: GAS (Strep pyogenes) Name diseases caused that are Suppurative infections:

Pharyngitis, Scarlet fever, Erysipelas, Impetigo, Necrotizing fasciitis, Strep Shock Syndrome

Organism: GAS (Strep pyogenes (Suppurative infections): ____: reddened pharynx with exudates. _____: diffuse erythematous rash on the chest and spreading to extremities. White coat on tongue. Complication of pharyngitis. _____: localized skin infection with pain, inflammation, lymph node enlargement and systemic symptoms. Raised skin, especially on legs but on face too. More common in kids.

Pharyngitis: reddened pharynx with exudates. Scarlet fever: diffuse erythematous rash on the chest and spreading to extremities. White coat on tongue. Complication of pharyngitis. Erysipelas: localized skin infection with pain, inflammation, lymph node enlargement and systemic symptoms. Raised skin, especially on legs but on face too. More common in kids.

Organism: A.aureus (Suppurative (pus forming) infections): _____: abscess in lungs (in immunocompromised); a severe form of necrotizing pneumonia with septic shock and high mortality. _____- in both Staph aureus and coagulase negative Staph. _____ infections - UTI, shunts, prosthetics, etc. In all species of Staph. Other Bacteremia, endocarditis, arthritis, osteomyelitis

Pneumonia and empyema: abscess in lungs (in immunocompromised); a severe form of necrotizing pneumonia with septic shock and high mortality. Wound infections - in both Staph aureus and coagulase negative Staph. Nosocomial infections - UTI, shunts, prosthetics, etc. In all species of Staph. Other Bacteremia, endocarditis, arthritis, osteomyelitis

What can a positive TB be due to(4)?

Positive Test due to: 1. Active TB - you have it, or recently 2. Inactive TB - dormant 3. Previous Infections 4. Vaccinated - Bacille Calmette-Guerin (BCG) vaccine. Not available in US. Interferes with skin test, not necessary, uncommon here. From the cell wall of the organism (protein derivative).

35.List the major signs and symptoms of TB infection

Productive, persistent cough Fever Weight loss Fatigue Night sweats Hemoptysis - cough blood Dyspnea - difficulty breathing Orthopnea - shortness of breath

Diseases causged by GBS (Strep agalactiae)?

Puerperal (childbirth) sepsis, Pneumonia, meningitis

Organism: A.aureus (toxin mediated): _____ (only in Staph): disseminated desquamation of epithelium in infants; blisters with no organisms or leukocytes. _____ (also in other enterotoxin-forming bacteria): from heat-stable enterotoxins, rapid onset with severe vomiting, diarrhea, cramping for 24 hrs. Diarrhea is watery and not bloody. Most common: processed meats, custard pastries, potato salad, ice cream. _____ (similar in S. pyogenes): multisystem intoxication

Scalded Skin Syndrome (only in Staph): disseminated desquamation of epithelium in infants; blisters with no organisms or leukocytes. Food poisoning (also in other enterotoxin-forming bacteria): from heat-stable enterotoxins, rapid onset with severe vomiting, diarrhea, cramping for 24 hrs. Diarrhea is watery and not bloody. Most common: processed meats, custard pastries, potato salad, ice cream. Toxic shock (similar in S. pyogenes): multisystem intoxication

17.Name and describe the mode of action of virulence factors that are enzymes. (mode of action, refer to slide 6 in first set of powerpoints)

See attachment

What causes septicemia? List the possible outcomes of Gram negative Septicemia and release of endotoxins? Why Gram negative septicemia is more dangerous than septicemia caused by Gram negative bacteria?

Septicemia is caused when bacteria migrate into the bloodstream. They can do this with their various spreading virulence factors or they can invade the bloodstream by direct access through a wound that opens access to the circulatory system. Gram Negatives are more dangerous because after they are dead they release their LPS/LOS and cause more severe side effects. Side effects of a gram negative sepsis include: hypotension, shock, DIC, hypoglycemia, vascular permeability, fever, decreased iron.

Word bank: sepsis, septicemia, and septic shock ______: Acute illness caused by infectious agents or their products circulating in the blood stream . blood poisoning. _____: Sepsis with hypotension, organ failure, lactic acidosis, oliguria, altered mental status, usually caused by endotoxin ____ : Condition resulting from the presence of bacteria or their toxins in the blood or tissues; the presence of pathogens or their toxins in the blood or other tissues. Systemic Response to infection.

Septicemia: Acute illness caused by infectious agents or their products circulating in the blood stream . blood poisoning. Septic Shock: Sepsis with hypotension, organ failure, lactic acidosis, oliguria, altered mental status, usually caused by endotoxin Sepsis: Condition resulting from the presence of bacteria or their toxins in the blood or tissues; the presence of pathogens or their toxins in the blood or other tissues. Systemic Response to infection.

Shiga toxin Organism: Mode of action: Effect on human body:

Shiga toxin Organism: Shigella; E. coli O157:H7 Mode of action: Enzymatically cleaves eukaryotic 28S rRNA resulting in inhibition of protein synthesis in susceptible cells. Effect on human body: Results in diarrhea, hemorrhagic colitis and hemolytic uremic syndrome.

13. Compare and contrast Staph and Strep( Extracellular Products) Streptococcus pyogenes: Staphylococcus aureus:

Streptococcus pyogenes: Gram (+) cocci in chains Beta-hemolytic (sometimes alpha) colonies Cell wall contains group A polysaccharides and M protein Staphylococcus aureus: Gram (+) cocci in clusters Beta-hemolytic (sometimes alpha) colonies; Cream-colored colonies Cell wall contains protein A

13. Compare and contrast Staph and Strep( Disease Potential) Streptococcus pyogenes: Staphylococcus aureus:

Streptococcus pyogenes: Impetigo Strep throat Wound infections Scarlet fever Puerperal fever Toxic shock Flesh-eating fasciitis Complications: glomerulonephritis, rheumatic fever, and cholera Staphylococcus aureus: Boils Scalded skin syndrome Wound infections Abscesses Impetigo Food poisoning Toxic shock syndrome

13. Compare and contrast Staph and Strep( Characteristics) Streptococcus pyogenes: Staphylococcus aureus:

Streptococcus pyogenes: Hemolysins: Streptolysins O and S Streptokinase DNase Hyaluronidase Staphylococcus aureus: Coagulase Hemolysins Leukocidin Hyaluronidase Nuclease Protease Penicillinase

Streptolysin Organism: Mode of action: Effect on human body:

Streptolysin Organism: Strep. pyogenes Mode of action: Kills RBCs, WBCs, epithelial cells. Tissue destruction. Effect on human body: Most infectious to humans, very dangerous. Can cause flesh-eating disease.

60. Define and give examples of toxins act as superantigens

Superantigens: toxins that stimulate the immune system by directly acting on T-cells and antigen presenting cells b. Pyrogenic exotoxins produced by staphylococcal and streptococcal species that act as potent stimulation of the immune system, pyrogenicity and enhancement of endotoxin shock.

What is the causative agent for plague?

Yersinia pestis causes plague

What are some diseases caused by Yersinia pestis? Explain

Zoonotic infection with humans as accidental host. Natural reservoir is rats, squirrels. rabbits, and domestic animals. Spread by flea bites or direct contact with infected tissues or person-to-person by inhalation of infectious aerosols from a patient with pulmonary disease. Bubonic plague: after bitten by flea, within a week person has high fever and painful bubo (inflammation of the lymph nodes) in the groin or axilla. Bacteremia develops rapidly and high mortality without antibiotics. Pulmonary (pneumonic) plague: shorter incubation (1-2 days). Fever, malaise, pulmonary symptoms within 1 day. Highly infectious by aerosols. Higher mortality rate than bubonic. Gastroenteritis (Y. enterocolitica): most common in kids. Contaminated food or water. Diarrhea, fever, abdominal pain 1-2 weeks. Disease involves the terminal ileum. Asymptomatic carriage: sometimes.

List important virulence factors including

a. Adhesions of pili/fimbriae to other surface molecules that facilitate attachment of bacteria to the host cell b. Ability to trigger actin arrangement in non-phagocytic cells leading to endocytosis c. Plasmids d. Endotoxin: a type of exotoxin produced by G (-) bacteria e. Exotoxin: proteins produced and secreted by both G (+) and G (-) bacteria f. Superantigens: triggers release of cytokines g. antigenic shift/drift h. proteases that break down IgA

12.List enzymes possessed by Staph and describe their modes of action (lecture notes and required readings) a. ____: coats bacteria in fibrin clot to prevent phagocytosis b. ____: Impedes progress of leukocytes to the infected area by clotting the surrounding capillaries c. ____: separates layers of epidermis causing scalded skin syndrome d. ____: breaks down hyaluronic acid component of tissue

a. Capsule: coats bacteria in fibrin clot to prevent phagocytosis b. Coagulase: Impedes progress of leukocytes to the infected area by clotting the surrounding capillaries c. Exfoliatin: separates layers of epidermis causing scalded skin syndrome d. hyaluronidase: breaks down hyaluronic acid component of tissue

26.What are the main characteristics of gas gangrene?

a. Clostridium perfringens i. Enters via trauma, puncture wound 1. Muscle swelling, pain, fever, foul-smelling drainage 2. Gas production; Air under the skin 3. Vesicle formation, combining into large blisters 4. Blisters filled with brown-red fluid 5. Pale skin color, later becoming dark red or purple 6. Progressive swelling around skin injury 7. Sepsis, Cuts the OXYGEN supply to tissue 8. Requires Surgical removal of dead tissue and antibiotic treatment

Name the 4 diseases (just the disease name) of clostridium)

a. Clostridium perfringens b. Clostridium tetani c. Clostridium botulinum d. Clostridium difficile

24.Name diseases caused by Clostridium spp. Name the virulence factors?

a. Clostridium perfringens causes gas gangrene - Alpha Toxin b. Clostridium tetani causes tetanus -Tetanospasmin c. Clostridium botulinum causes botulism - Botulinum Toxin A d. Clostridium difficile causes toxic megacolon, pseudomembranous colitis, perforation of the colon, and diarrhea. Virulence factors of Clostridium difficile include the exotoxins: Toxin A and Toxin B

63. List examples of endospore forming bacteria and the diseases caused by them

a. Clostridium: Gas gangrene, food poisoning, diarrhea and colitis, tetanus, botulism b. Clostridium botulimum c. Clostridium tetani d. Clostridium perfringens e. Clostridium difficile f. Bacillus anthracis: causes anthrax

55. What are the major signs and symptoms of meningitis?

a. Headache, vomiting, pain, cranial pressure, stiff neck, altered muscle control b. If it hits the brain you get encephalitis which results in behavior changes, coma and death c. Diagnosed via spinal tap d. Aseptic meningitis: meningitis not caused by microbes: caused by virus (enteroviruses) or protozoa or fungus (cryptococcus) : treatment is amphotericin B for fungal meningitis e. Bacterial meningitis: Babies : Group B, f. Teens: N. Meningitidis, g. all others S. pneumo i. S. pneumoniae (Vaccine available) : leading in adults ii. N. meningitidis (Vaccine available): can be part of normal flora can be epidemic. It uses fimbriae, capsule, and LOS. Meningococcal meningitis iii. H. influenzae B (Vaccine available) iv. L. monocytogenes : immunocompromised people : babies and elderly.

61. Describe and give examples of Two Components (A/B type) toxins

a. Mainly bacterial protein exotoxins in which the subunit A component is responsible for enzymatic activity and the subunit B component is responsible for binding to a specific receptor on host cell membranes and transferring the enzyme across the membrane. b. Cholera Toxin, Diphteria toxin, E. coli heat-liable toxin LT, Shiga toxin are examples.

43.How Neisseria and Chlamydia may affect male and female differently

a. Male: Chlamydia: burning, no pus urethral discharge. Can cause blockage and sterility. b. Male: Gonorrhoeae: burning pus filled yellowish discharge, with scarring can cause sterility. 20% infection rate 95% symptomatic c. Female: Chlamydia : pelvic inflammatory disease, mostly asymptomatic in the vaginal area. Increases risk for cervical cancer. Can cause sterility or ectopic pregnancy. d. Female: Gonorrhoeae: cervicitis, PID, permanent sterility. 50% infection rate, 70+% chance for asymptomatic infection. Back and abdominal pain, fever and inflammation. Can cause miscarriage via PID symptoms.

49.Name a selective media used to select for Staph, and Neisseria.

a. Neisseria: Chocolate Agar b. Staph: Mannitol-Salt Agar (MSA) and Blood agar (beta hemolytic in Staph Aureus) Also Chromagar for MRSA

42.Which diseases caused by both Neisseria and Chlamydia

a. Pelvic inflammatory disease b. STIs Urogenital infections (urethral, endocervical) c. Eye infection d. Asymptomatic infections (although not mentioned in lecture, both can also cause rectal infections, and rarely oral infections)

47.List the major virulence factors possessed by N. gonorrhoeae.

a. Pili (fimbriae)- most significant VF. Lots of IgA secreted b. The pilin proteins have a conserved and highly variable region. c. Transferrin/lactoferrin iron-binding protein d. LOS- lipooligosaccharide; it has lipid A and endotoxin activity e. Capsule

59. Describe how horizontal gene transfer(HGT) is involved in spread of pathogenicity among bacteria. Name some toxins coded by genes that are passed on using HGT

a. Regulatory genes that produce toxins are found on bacterial chromosomes, plasmids, and lysogenic bacteriophages and sometimes can occur on pathogenicity islands. Genetic exchange occurs through conjugation and transduction. HGT of genes that encode virulence is known to occur between species of bacteria with the intestinal tract the ideal habit for genetic transfer. b. Alpha toxin, Cholera enterotoxin, E. coli LT/ST toxins, shiga toxin, Toxin A/B, Staphylococcus enterotoxins, and toxic shock syndrome toxin.

62. List diseases caused by Spirochetes

a. Spirochetes are thin, helical, gram-negative bacteria b. Borrelia burgdorferi (garinii, afzelii): causes Lyme disease; erythema migrans; cardiac/neurologic/rheumatologic abnormalities is transmitted by hard ticks (affects rodents, deer, domesticated pets) c. Borrelia recurrentis: causes Epidemic relapsing fever through transmission of human body louse and contains no animal host. d. Borrelia species: causes Endemic relapsing fever through transmission by tick bite (tick- borne) of a soft tick that is carried on rodents and small animal reservoirs. e. Leptospira interrogans: Causes Leptospirosis: mild, viral like illness to severe multi- organ illness (Weil disease). Transmission is by exposure to infected urine or tissues or rodents, dogs, farm animals, wild animals. f. Treponema pallidum: causes Syphilis: primary, secondary, tertiary and congenital forms. Transmission occurs through congenitally or through sexual contact.

53. What are the characteristics of typhoid fever and extra intestinal diseases caused by Salmonella

a. The bacteria that cause enteric fever pass through the cells lining the intestines and are engulfed by macrophages. They replicate after being transported to the liver, spleen, and bone marrow. After 10-14 days after ingestion, gradual increasing fever with nonspecific complaints of headache, myalgias, malasise, and anorexia and persist for one week or longer followed by GI symptoms. This is due to the intimal bacteremic phase that is followed by colonization of the gall bladder (carrier state) and then reinfection of the intestines. b. Extra-intestinal: specticemia, fever, shock, lesions in the kidneys and lungs

Describe characteristics of disease caused by Salmonella.

a. Through a type-III secretion mechanism causes mild gastroenteritis (mediation through the release of prostaglandins that stimulates cAMP that activates fluid secretion) to serious enteric fever. b. Gastroenteritis: most common form of salmonellosis that occurs 6-48 hours after consumption of contaminated water or food that persists with nausea, vomiting, and non- bloody diarrhea. Fever, abdominal cramps, myalgias, and headache are common that last 2-7 days. c. Septicemia: the risk is higher in those with pediatric and geriatric patients and in immunocompromised patients. Symptoms are similar to gram negative bacteremias but can also contain suppurative symptoms including: osteomyelitis, endocarditis, arthritis). d. Enteric fever: The bacteria that cause enteric fever pass through the cells lining the intestines and are engulfed by macrophages. They replicate after being transported to the liver, spleen, and bone marrow. After 10-14 days after ingestion, gradual increasing fever with nonspecific complaints of headache, myalgias, malasise, and anorexia and persist for one week or longer followed by GI symptoms. This is due to the intimal bacteremic phase that is followed by colonization of the gall bladder (carrier state) and then reinfection of the intestines. Extra-intestinal: specticemia, fever, shock, lesions in the kidneys and lungs e. Asymptomatic colonization: chronic colonization for more than one year after symptomatic disease develops occurs with the gallbladder being the reservoir in most patients.

What types of infections does group A streptococci cause?

d. Types of infections: -Skin Infections: Impetigo, Erysiplas -Invasive/Systemic Infections: Necrotizing fasciitis, Scarlet Fever -Respiratory Infections: Pharyngitis (Strep Throat)

a. _____- long term infection b. ____- infectious agent multiplying w/ great intensity c. ____- persists in tissues for long periods of time, where during much of that time there are no symptoms (herpes)

a.Chronic- long term infection b. Fulminating- infectious agent multiplying w/ great intensity c. Latent- persists in tissues for long periods of time, where during much of that time there are no symptoms (herpes)

Strep. pnuemoniae is _____ hemolytic, but more invasive than toxigenic due to its main virulence Factor: a ____, cytotoxin neumolysin.

alpha, capsules

6. What are the important diseases of group A streptococci?

c. Diseases: Strep throat- respiratory, Systemic : necrotizing fasciitis, scarlet fever - complications from Strep throat if not resolved- can evolve into rheumatic fever after that, Skin: Impetigo and Erysiplas

d. _____- developed during stay at hospital or care facility e. ______- from endogenous microbiota when host resistance is already very low or immunocompromised f. ______- more than 1 type of organism present at same time (kochs postulate: 1 disease for 1 organism) g. ____- pus forming *different than ___-fever

d. Nosocomial- developed during stay at hospital or care facility e. Opportunistic- from endogenous microbiota when host resistance is already very low or immunocompromised f. Polymicrobial- more than 1 type of organism present at same time (kochs postulate: 1 disease for 1 organism) g. PYOgenic- pus forming *different than ____-fever